Published in:
Open Access 01-10-2010 | Clinical Practice: Clinical Images
Leriche Syndrome
Published in: Journal of General Internal Medicine | Issue 10/2010
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A 58-year-old man was admitted for coronary angiography after several months of worsening angina. After two failed femoral catheterization attempts due to guide-wire obstruction, access was achieved through the right brachial artery. Catheterization revealed severe three-vessel coronary artery disease. An aortogram was performed revealing a complete occlusion of the aorta inferior to the renal arteries. A computed tomography angiography with runoff demonstrated significant collateral circulation with reconstitution of the distal femoral arteries. (see image 1)
On further history, the patient noted bilateral calf and buttock claudication, erectile dysfunction and a 40-pack year smoking history. Despite complete aortic occlusion, the patient had 1+ palpable posterior tibial and dorsalis pedis pulses due to extensive collateralization. (see image 2) 
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